Diabetes Research Group, 74939Medizinische Klinik und Poliklinik IV, LMU Klinikum, München, Germany.
Klinik und Poliklinik für Radiologie, LMU Klinikum, München, Germany.
Diab Vasc Dis Res. 2022 Jan-Feb;19(1):14791641211070281. doi: 10.1177/14791641211070281.
Skeletal muscle contributes significantly to insulin sensitivity in humans. However, which non-invasive measurement best reflects this contribution remains unknown. Consequently, this paper compares morphologic and functional measurements.
We conducted a cross-sectional analysis of 144 premenopausal women enrolled in the "Prediction, Prevention, and Sub-classification of Type 2 Diabetes" (PPSDiab) cohort study. For the analysis, we quantified insulin sensitivity by oral glucose tolerance testing and, in a subgroup of 30 women, euglycemic clamp. To assess skeletal muscle, we measured volume by magnetic resonance imaging, intramyocellular lipid content by magnetic resonance spectroscopy, and physical fitness by cardiopulmonary exercise testing.
The mean age of the cohort was 35.7 ± 4.1 years and 94 participants (65%) had a history of gestational diabetes mellitus. Of the morphologic and functional muscle parameters, the maximum workload achieved during cardiopulmonary exercise testing associated most closely with insulin sensitivity (standardized beta = 0.39; < .001). Peak oxygen uptake also demonstrated significant associations, whereas muscle volume and intramyocellular lipid content displayed none.
Functional measurements provided a better assessment of the muscular contribution to insulin sensitivity than morphologic measurements in premenopausal women. In particular, exercise testing rendered an easy and cost-effective method applicable in clinical settings and other human studies.
骨骼肌对人体的胰岛素敏感性有重要贡献。然而，哪种非侵入性测量方法最能反映这种贡献仍不清楚。因此，本文比较了形态学和功能测量。
我们对参加“2 型糖尿病的预测、预防和亚分类”（PPSDiab）队列研究的 144 名绝经前妇女进行了横断面分析。在分析中，我们通过口服葡萄糖耐量试验和在 30 名女性亚组中进行的正葡萄糖钳夹试验来量化胰岛素敏感性。为了评估骨骼肌，我们通过磁共振成像测量体积，通过磁共振波谱测量细胞内脂质含量，通过心肺运动试验测量身体适应性。
队列的平均年龄为 35.7 ± 4.1 岁，94 名参与者（65%）有妊娠糖尿病史。在形态学和功能肌肉参数中，心肺运动试验中达到的最大工作量与胰岛素敏感性的相关性最强（标准化β=0.39； <.001）。峰值摄氧量也显示出显著的相关性，而肌肉体积和细胞内脂质含量则没有相关性。
在绝经前妇女中，功能测量比形态学测量能更好地评估肌肉对胰岛素敏感性的贡献。特别是，运动测试提供了一种简单且具有成本效益的方法，适用于临床环境和其他人类研究。
